SP776EXPANDED CRITERIA DONORS AFTER CARDIAC DEATH: AN INCREASING AND USEFUL SOURCE FOR KIDNEY TRANSPLANTATION

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INTRODUCTION AND AIMS: Controlled donation after cardiac death (cDCD) programs in Spain have got 739 cDCD donors 2012-2016. Selection criteria have been progressively expanded. Our aim was to compare characteristics and clinical outcomes of our expanded criteria cDCD (ECcDCD) vs standard ones (SCcDCD) METHODS: Observational prospective multicenter study. Systematic inclusion of every kidney transplant-KTx from cDCD at the 19 units that agreed participation. RESULTS: We included 311c DCDdonors aged 57.2years. Nineteen kidneys were discarded for several reasons and 75 were transferred and implanted in centers out of our group. We included 118 patients who received organs from ECcDCD and 410 recipients of SCcDCD. Mean follow-up 13m. As expected, ECcDCD were older (72y vs SCcDCD 52.3y, p<0.001) with more comorbid conditions (diabetics 26.2% vs 13.9%; p=0.03), dead due to CV events (80.6% vs 71.4%) and higher SCr(1.9 vs 1.1 mg/dl). Recipients of ECcDCD grafts were also older (65.5 vs 53.8 p<0,001), with higher comorbidity (DM 48,4% vs 25,4%;p<0.001) mainly coming from HD programs (87.7% vs 73.8%, p<0,05) but with a similar proportion of previous KTx(6,8% vs 7,7%). Ischemia times were similar: Cold 12 vs 13.1h and warm: 26.9 vs 27.8min, but with a higher HLA-mismatch(4.0 vs 3.4; p<0.001) and pre-existing Ab rates (11.9 vs 4.8;p=0.003). The use of Thymoglobulin was less frequent in ECcDCD vs SCcDCD (52,5 vs 71.6 %;p<0.001). Recipients of ECcDCD grafts presented similar renal outcomes than SCcDCD: primary graft failure-PGF(2.5 vs 3.0%), DGF(52,5 vs 46,9%) and late graft loss at the end of follow-up (2.6 vs 3.6%). Graft survival analysis was similar in both groups but the “best 1styear eGFR” was lower in ECcDCD recipients (47,7 vs 57,4ml/min, p<0.001). Recipient mortality rate was higher in EC-group (7.8 vs 3.3 %, p=0.04) but, as recipients were older and more comorbid, the effect of EC on mortality disappeared in the multivariate model when recipient age was included. SP776 Figure

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